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- Title
In-plane three-step needle insertion technique for ultrasoundguided continuous femoral nerve block after total knee arthroplasty : a retrospective review of 488 cases.
- Authors
Hyeon Ju Shin; Jung Sub Soh; Hyong Hwan Lim; Bumjoon Joo; Hye Won Lee; Hae Ja Lim
- Abstract
Background: Continuous femoral nerve block (CFNB) improves postoperative analgesia after total knee arthroplasty (TKA). The aim of this study was to investigate the clinical efficacy and complications of our in-plane three-step needle insertion technique that was devised to reduce the risk of direct femoral nerve injury during CFNB in anesthetized patients. Methods: This retrospective study included 488 patients who had undergone TKA. Ultrasound (US)-guided CFNB was performed under general or spinal anesthesia using an in-plane, three-step needle insertion technique. The success rate and difficulties of catheter placement, clinical efficacy of analgesia, and complications were recorded. Results: Femoral catheters were placed with a 100% success rate. In 488 patients, real-time US imaging revealed easy separation of the fascia iliaca and the femoral nerve following injection of local anesthetic through a Tuohy needle. Verbal numerical rating scale pain scores (0-10) were 2.0 ± 1.2, 3.5 ± 1.9, 3.2 ± 1.7, 2.9 ± 1.3, and 2.5 ± 1.1 at 1, 6, 12, 24 and 48 h postoperatively. No femoral hematoma, femoral abscess, or neurologic complications, including paresthesia or neurologic deficits, were observed during the 8-week follow-up period. Conclusions: This retrospective study suggests that an in-plane three-step needle insertion technique for CFNB may reduce the risk of femoral nerve injury in anesthetized patients.
- Subjects
NERVE block; TOTAL knee replacement; MEDICAL ultrasonics; FEMORAL nerve; CATHETERIZATION; NERVOUS system injuries; DIAGNOSTIC ultrasonic imaging
- Publication
Korean Journal of Anesthesiology, 2016, Vol 69, Issue 6, p587
- ISSN
2005-6419
- Publication type
Article
- DOI
10.4097/kjae.2016.69.6.587